睾酮皮下注射：如何自行注射

最后更新： 2026年6月9日

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在之前的一篇文章中，我向您展示了如何将睾酮注射到肌肉中（肌肉注射，IM）。今天，我想向您介绍一种在全球日益流行、更温和、更简便的替代方法：睾酮皮下注射（SC）——即注射到皮肤正下方的脂肪层，而非深入肌肉。

我有许多接受睾酮替代疗法的患者觉得传统的肌肉注射（IM）不舒服，有些人还需要家人帮忙才能注射到臀部或大腿肌肉。好消息是，现代研究表明皮下注射途径同样有效——而且通常舒适得多，也更易于自行注射。

为何考虑皮下注射途径？

近 80 年来，肌肉注射（IM）睾酮一直是标准方法。它价格低廉，能产生可预测的睾酮水平——但难以自行注射，且常伴有不适感。近来，皮下注射（SC）途径日益受到欢迎，因为自行注射要容易得多，现有证据也支持其可行性。

皮下注射（SC）途径的主要优势包括：

• 自行注射更简便：无需注射到深层肌肉，也无需他人帮忙。
• 疼痛更轻：更细的针头和更浅的注射使大多数男性几乎无痛。
• 无坐骨神经损伤风险：这是臀部肌肉注射（IM）已知的（虽然罕见）风险。
• 激素水平稳定：皮下注射（SC）能产生更平稳、更稳定的睾酮水平，峰值与谷值波动更小。
• 更好的依从性：由于方便且舒适，患者更有可能长期坚持治疗。

发表于 The Journal of Urology 的一项具有里程碑意义的 52 周临床试验发现，每周一次的皮下睾酮庚酸酯自动注射器能产生稳定的睾酮水平，波动很小，且 超过 95% 的患者报告没有与注射相关的疼痛。作者得出结论：皮下注射（SC）途径是一种安全、耐受性良好且几乎无痛的选择（Kaminetsky et al., J Urol 2019）。

肌肉注射（IM）与皮下注射（SC）：有何区别？

Feature	Intramuscular (IM)	Subcutaneous (SC)
Injection depth	Deep into the muscle	Into the fat layer under the skin
Common site	Buttock or outer thigh	Abdomen (belly) or thigh
Needle size	Longer, larger gauge	Shorter, smaller gauge (23-25G)
Pain level	Moderate discomfort	Minimal — virtually painless
Self-administration	Difficult; may need help	Easy to do alone
Testosterone levels	Larger peaks and troughs	Smoother, more stable

Things You Need to Prepare

• Alcohol swabs
• Your prescribed testosterone vial (e.g., testosterone enanthate or cypionate) — always check the expiry date
• A 1 mL Luer-Lok syringe (preferred to prevent the needle from disengaging due to the oil’s viscosity)
• A drawing-up needle (18-21G) to draw the testosterone from the vial
• A fine short injection needle (23-25 gauge, 5/8-inch) for the subcutaneous injection
• A sharps disposal container

Where to Inject: The Landmark

The two recommended sites for subcutaneous testosterone injection are:

• The abdomen (belly): Inject into the fatty tissue 3 to 5 cm to the side of the belly button (umbilicus). Avoid the area too close to the navel.
• The thigh: The fatty tissue of the front or outer thigh is also a suitable site.

Gently pinch a fold of skin and fat to lift it away from the muscle. This helps ensure the injection goes into the subcutaneous layer and not the muscle.

Step-by-Step: How to Do a Subcutaneous Testosterone Injection

⚠️ Important: Do NOT attempt your first injection by yourself. You must be trained and supervised by a medical professional until you are fully competent.

1. Wash your hands thoroughly and sit in a comfortable chair with your supplies ready.
2. Decide on your injection site (abdomen 3-5 cm beside the navel, or thigh). Alternate sites with each injection.
3. Draw the prescribed testosterone dose from the vial using the larger drawing-up needle (18-21G) on your Luer-Lok syringe.
4. Remove all air bubbles from the syringe (air must not be injected).
5. Replace the drawing-up needle with the fine injection needle (23-25G).
6. Clean the injection site with an alcohol swab and let it air-dry.
7. Gently pinch a fold of skin and insert the needle at a 45 to 90-degree angle into the fatty tissue.
8. Slowly inject the testosterone over several seconds.
9. Remove the needle and gently press the site with a clean cotton ball or gauze. Do not rub.
10. Dispose of the needle and syringe safely in your sharps container.

Note: For the ultralong-acting ester testosterone undecanoate (a larger volume), the injection should be given more slowly over 2-3 minutes. Discuss the correct technique with your urologist, as this formulation has specific considerations.

Recommended Dose

Based on clinical studies, a common starting dose for subcutaneous testosterone enanthate or cypionate is 75 mg once weekly. This slightly lower weekly dose is usually sufficient to achieve healthy testosterone levels. Your doctor may adjust the dose down to 50 mg or up to 100 mg per week based on your blood test results. On-treatment testosterone should be measured midway between injections, and monitoring should continue periodically.

Possible Side Effects

Local reactions are usually mild and temporary, and may include:

• Minor redness, itching, or a small painless lump at the injection site
• Light bruising or bleeding

Because testosterone levels achieved via SC are similar to IM, the general systemic effects of testosterone therapy still apply and require monitoring — including a possible rise in red blood cell count (hematocrit), blood pressure, and PSA. This is why regular follow-up with your urologist is essential.

If you would like to discuss whether subcutaneous testosterone therapy is right for you, or to be trained in proper self-injection technique, Dr. Soarawee Weerasopone offers consultations at Bangkok Hospital Headquarters. 在此预约咨询.

常见问题解答

Is subcutaneous testosterone injection as effective as intramuscular?

Yes. Multiple studies show that subcutaneous (SC) injection of testosterone enanthate or cypionate produces serum testosterone levels comparable to the intramuscular (IM) route. In fact, SC injection often produces smoother, more stable hormone levels with smaller peaks and troughs, while being easier to self-administer and less painful.

Where do I inject subcutaneous testosterone?

The two recommended sites are the abdomen — 3 to 5 cm to the side of the belly button — and the fatty tissue of the thigh. Gently pinch a fold of skin and fat, then insert the fine needle at a 45 to 90-degree angle. Always rotate injection sites to avoid irritation.

What size needle should I use for subcutaneous testosterone?

Clinical studies typically use a 1 mL Luer-Lok syringe with a fine 23 to 25-gauge, 5/8-inch needle for the injection itself, and a larger 18 to 21-gauge needle to draw the oil-based testosterone from the vial. A Luer-Lok syringe is preferred because the oil’s viscosity can otherwise cause the needle to detach.

Is subcutaneous testosterone injection painful?

For most men, no. In a 52-week clinical trial, more than 95% of patients reported no injection-related pain with weekly subcutaneous testosterone. The smaller needle and shallower injection make it virtually painless compared with the traditional intramuscular route.

Can I switch from intramuscular to subcutaneous injections?

Often, yes. Many patients successfully switch from IM to SC injection while maintaining stable testosterone levels. Studies in patients who switched routes found no significant change in hormone levels, and most preferred not to return to IM injection. Always make this change under the guidance of your urologist.

**免责声明：** 本内容由曼谷医院总院的认证泌尿科医生 Soarawee Weerasopone 医生撰写和审阅。本内容仅用于教育目的，不构成医疗建议。在开始任何医疗治疗前，请务必咨询合格的医疗专业人士。.